John Hajek

A review of approaches to improve participation of culturally and linguistically diverse populations in clinical trials

The under-representation of culturally and linguistically diverse participants in clinical trials is an ongoing concern for medical researchers and the community. The aim of this review is to examine the complex issue of recruiting culturally and linguistically diverse (CALD) older people to medical research and to examine responses to these issues. The review focuses on (1) trends in the existing literature on barriers to and strategies for recruiting CALD and older people to clinical research, (2) issues with informed consent for CALD populations, and (3) the efficacy of innovative approaches, including approaches incorporating multimedia in research and consent processes. The literature indicates that predominant barriers to greater involvement of CALD patients in clinical trials are communication, including literacy and health literacy considerations; English language competence; and cultural factors in the research setting such as mistrust of consent processes, as well as considerable practical and logistical barriers, including mobility considerations. Some evidence exists that incorporating multimedia resources into the informed consent process can improve patient understanding and is preferred by patients, yet these findings are inconclusive. A multi-methodological approach, including the use of culturally and linguistically sensitive multimedia tools, may help address the issue of low inclusion of CALD groups in clinical research. Researcher education needs to be taken into account to address preconceptions about CALD resistance to research participation and to raise awareness of cultural concerns in regard to research participation.

Old French nasalization and universals of sound change

AbstractChanging patterns of assonance in early Old French texts have traditionally provided the basis for the claim that vowel height has a universally predictable effect on the development of distinctive nasalization over time. However, the results of recent studies cannot be accounted for by such a hypothesis. Furthermore, an alternative hypothesis suggests that the same patterns of assonance reflect modifications in vowel quality rather than nasality. Additional cross-linguistic and phonetic data examined here further undermine the purportedly universal character of the development of distinctive nasalization in Old French.

The phonetic status of the labial flap

The labial flap is a speech sound which has received little attention in the literature. In this paper, we document the articulation of the sound, including audio and video data from Mono (D.R. Congo, Ubangian). The sound is attested in over sixty languages and has been incorporated into the phonological system of at least a dozen of them. The sound is easily describable in terms of values of phonological features or phonetic parameters, and it appears to have arisen independently in at least two regions of the world. These factors argue for the inclusion of the sound in the International Phonetic Alphabet.

Minority language speakers as migrants: some preliminary observations on the Sudanese community in Melbourne

The language problems faced by migrants may be more complex when they come from a minority language group in their homeland. The new arrivals may find that there are few, or even no, speakers of their language in the community to which they have moved. Then decisions have to be made as to whether to attempt to maintain the native language and also whether to join in larger groupings of people from the country of origin, groups that may use dominant languages of the home country or other languages of wider communication. Such migrants can be expected to be involved in various networks based on different languages and to have complex allegiances and identities involving the various networks and languages. We explore these issues by considering the case of speakers of minority languages from Sudan who have settled in Melbourne. More than 40 languages are represented in this community and most of these are minority languages in Sudan. We present three case studies of members of this community and discuss the social networks that are available to speakers of these languages and the various factors that influence the language use and language choices of the people from these groups.

Community Languages and LOTE Provision in Victorian Primary Schools: Mix or Match?.

The introduction of LOTE programs in primary schools in Victoria, as part of the normal curriculum, dates back to the early 1980s with the introduction and government support of primary level community language programs. In 1983, the Victorian government employed the first supernumerary community language teachers in primary schools to aid in language maintenance and development for LOTE speakers. Initially, around 130 such teachers were employed in a small number of primary schools, supported by extra ethnic teaching aides and community language consultants (Ozolins 1993).

Health professionals’ views on health literacy issues for culturally and linguistically diverse women in maternity care: barriers, enablers and the need for an integrated approach

Objective To identify health literacy issues when providing maternity care to culturally and linguistically diverse (CALD) women, and the strategies needed for health professionals to collaboratively address these issues. Methods A qualitative case study design was undertaken at one large metropolitan Australian hospital serving a highly CALD population. Semistructured interviews were conducted with a range of maternity healthcare staff. The data were analysed thematically. The study is informed by a framework of cultural competence education interventions for health professionals and a health literacy framework. Results Eighteen clinicians participated in the interviews (seven midwives, five obstetricians, five physiotherapists, one social worker, and one occupational therapist). Emergent themes of health literacy-related issues were: patient-based factors (communication and cultural barriers, access issues); provider-based factors (time constraints, interpreter issues); and enablers (cultural awareness among staff, technology). Conclusions There are significant health literacy and systemic issues affecting the hospitals provision of maternity care for CALD women. These findings, mapped onto the four domains of cultural competence education interventions will inform a technology-delivered health literacy intervention for CALD maternity patients. This approach may be applied to other culturally diverse healthcare settings to foster patient health literacy. What is known about the topic? There are health inequities for pregnant women of culturally and linguistically diverse (CALD) backgrounds. Low health literacy compounded by language and cultural factors contribute to these inequities and access to interpreters in pregnancy care remains an ongoing issue. Pregnancy smart phone applications are a popular source of health information for pregnant women yet these apps are not tailored for CALD women nor are they part of a regulated industry. What does this paper add? This paper provides clinician and language service staff perspectives on key health literacy issues that are both patient-based and provider-based. This research confirms that the complex interplay of social and practical factors contributes to and perpetuates low health literacy, creating barriers to health access; it also highlights several enablers for increasing CALD health literacy and access. These include greater health practitioner awareness and accommodation of CALD womens needs and the provision of culturally and linguistically appropriate eHealth resources. What are the implications for practitioners? eHealth resources are emerging as valuable enabling tools to address the health literacy and information needs of pregnant women. However, these resources need to be used adjunctively with health practitioner communication. Both resource developers and health practitioners need to understand issues affecting CALD patients and their needs. Developers need to consider how the resource addresses these needs. Training of health professionals about culture-specific issues may help to enhance communication with, and therefore health literacy among, individual cultural groups. Further, formalised language and interpreting training of bi- or multilingual health professionals is advised to ensure that they are able to interpret to a professional standard when called on to do so.

Closure duration as an acoustic correlate of the word-initial singleton/geminate consonant contrast in Kelantan Malay

Abstract Closure duration has been established cross-linguistically as the universally most reliable and consistent acoustic feature of consonant gemination. In this study, we conduct an acoustic phonetic analysis of the word-initial singleton/geminate consonant contrast in Kelantan Malay (KM) in order to explore the extent to which closure duration marks such a contrast in this Malay variety. KM is particularly unusual among the world׳s languages in that the contrast is restricted to word-initial position. A corpus of elicited materials consisting of singleton/geminate voiceless stops, voiced stops and sonorants were produced in words in isolation (i.e., utterance-initial position) and in a carrier sentence (i.e., utterance-medial position) by sixteen native speakers of KM. Results show that closure duration is a robust acoustic correlate of the consonant contrast in KM, i.e., word-initial geminates in KM are always associated with significantly longer closure duration than their corresponding singletons. The closure duration differences between singletons and geminates are also similar across utterance positions (at least for voiced stops and sonorants). In utterance-medial contexts, the effect is particularly strong in the closure duration of voiceless stops. Overall, closure duration is indeed a highly robust acoustic marker for this cross-linguistically rare word-initial consonant contrast in KM.

Consonant inventories as an areal feature of the New Guinea-Pacific region: Testing Trudgill's hypotheses

Abstract Trudgill has proposed that the size of the phonological inventory for a language correlates with the extent of language contact, with isolated small languages having very small or large inventories, and provides evidence for his claim from the Pacific region. The claim is scrutinised in light of the history and size of the language communities. Language contact is also seen to have contributed to the small and large inventories found in the region.

A crosslinguistic lexicon of the labial flap

We provide a large sample of the occurrences of the labial flap in the worlds languages, including audio and video data from the Mono dialect of Mid-Southern Banda. This sample provides the evidence for Olson and Hajeks (2003) crosslinguistic generalizations concerning the articulation, the geographic distribution, the genetic distribution, and the phonological status of the speech sound.

Address in Italian Academic Interactions: The Power of Distance and (Non)-Reciprocity

The chapter offers a detailed description of address practices in Italian academic interactions, based on the reported usage of address forms by students and lecturers via questionnaires. The data reveal that the reciprocal use of V form Lei is the main strategy to convey respect and distance. However, they also show that a frequent practice is the non-reciprocal use of pronouns (Lei-tu) and the combination of lexical forms encoding various degrees of social distance (names, titles, honorifics). Address non-reciprocity is perceived as the natural reflection of different roles and relative age, and is evaluated positively by the majority of students, the increase in familiarity putting students at ease inside and outside class.